Order Contact Lenses Name*Please provide your first and last name. First Last Email Address* Phone Number*Ship to Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit card number:* Please enter your credit card numberExpiration date:* Please enter your credit card expiration dateCvv:* Please enter your credit card cvv codeBilling zip code:* Enter your billing zip codePreferred Method of Communication*--Please Select--EmailPhoneSupply Needed*--Please Select--12 months6 months3 monthsChoice of:* Yes, process my payment and ship my contact lenses. Contact me to review my order. Delivery Option*--Please Select--Pick-up from OfficeDelivery, 5-7 business daysCall us before 2PM to determine availability and pricing*Delivery is $8.Your request will not be filled until reviewed by a technician and confirmed by phone or email, thank you.Additional Notes*